Repeatedly missing GP appointments may indicate greater risk of death from all causes, particularly in patients with long-term conditions.
Published in BMC Medicine, new research suggests patients with mental-health-based long-term conditions are more likely to miss appointments. And it’s advised that general practices and other services within the UK National Health Service (NHS) may need to consider how to best engage with patients who are repeatedly missing GP appointments.
The likelihood of missing GP appointments
Researchers at the Universities of Glasgow, Aberdeen and Lancaster, Scotland, found that the more long-term conditions an individual had, the more likely they were to miss appointments.
Of the 824,374 patients whose data were examined in this study, 59% had one or more long-term conditions, while 13.3% had four or more.
Patients with no long-term conditions (LTCs) were less likely to miss GP appointments than patients with long-term conditions.
Out of the 439, 592 patients who did not miss any GP appointments over a three-year period 51.5% had no LTCs, whereas 41.6% had one to three LTCs and 7% had four LTCs.
Out of 59, 340 patients who missed three or more appointments per year over the same three-year period, 40.1% had four or more LTCs, 50.1% had one to three LTCs, and 9.8% had no LTCs.
Long-term conditions associated with missing GP appointments
Mental-health-based long-term conditions were found to be associated with a higher risk of missing appointments than physical long-term conditions.
One to three mental health comorbidities were associated with a 30% higher risk of missing appointments compared to those who had no LTCs, and patients with four or more mental health LTCs were twice as likely to miss appointments. Patients with one to three physical morbidities were 16% more likely to miss appointments than those with no LTCs, whereas those with four or more physical LTCs were at 38% higher risk of missing appointments.
Dr Ross McQueenie, the corresponding author of the study, explains: “Patients with a higher number of missed appointments were also at greater risk of death within the following year.
“Those with long-term physical conditions who missed two or more appointments per year had a threefold increase in all-cause mortality compared with those who missed no appointments.
“Patients with only mental health conditions who missed more than two appointments per year had an eightfold increase in all-cause mortality compared with those who missed no appointments.
“Patients diagnosed with long-term mental health problems, who died during the follow-up period, were more likely to die prematurely, often as a result of external factors such as suicide, rather than of natural causes.”
It is important to note that the observational nature of this study does not allow for conclusions about cause and effect. The authors of the study note that it is unlikely that the relationship between missed appointments and mortality is directly causal.
